Decision-Making and Role Shifts as They Affect the Consultation Interface

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Abstract
WHEN THE psychiatrist comes to work as a consultant in a medical, dermatological, or surgical clinic, he is following the path of the technical advisor in a foreign country or of the Peace Corps volunteer. The Peace Corps volunteer and the technical consultant are warned that they are entering a different culture and a different social system. They are given a period of orientation in which the new society and culture are described and they are cautioned about the pitfalls. The psychiatric consultant moving into a nonpsychiatric clinic has no such forewarning. He knows that some physicians are propsychiatry and some physicians are antipsychiatry and that many jokes are made about the psychiatrists, but, after all, they are all members of the medical culture, with the same training, the same values, the same status, and basically the same roles relative to their patients. The consultant might expect that if he